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pattyz · 10-12-2008, 08:05 AM

Chemotherapy induces regression of brain metastases in breast carcinoma

Dutzu Rosner, MD *, Takuma Nemoto, MD, Warren W. Lane, PHD Departments
of Breast Surgery and Biomathematics, Roswell Park Memorial Institute,
Buffalo, New York

*Correspondence to Dutzu Rosner, Department of Breast Surgery, Roswell
Park Memorial Institute, 666 Elm Street, Buffalo, NY 14263

Funded by: National Cancer Institute, Department of Health and Human
Services.; Grant Number: CA-16056

Abstract: This study improves treatment options and ultimately survival
by using systemic chemotherapy in brain metastases from breast
carcinoma, since most of these patients have disseminated disease and a
dismal prognosis when treated by conventional brain irradiation alone.

One hundred consecutive patients with symptomatic brain metastases
documented by radionuclide and/or computerized tomography scan were
treated with systemic chemotherapy. Fifty of 100 patients demonstrated
an objective response of brain metastases which was similar for
extracranial metastases. There were 10 complete responders (CR), 40
partial responders (PR), 9 stable, and 41 nonresponders.

Median duration of remission was 10+ months for CR and 7 months for PR
(range, 2-72 months). Primary chemotherapy of brain metastases yielded
responses in 27 pf 52 patients (52%) treated with Cytoxan
(cyclophosphamide) (C), 5-fluorouracil (F) and prednisone (P); 19 of 35
(54%) receiving CFP-methotrexate (M) and vincristine (V); 3 of 7 (43%)
treated with MVP, and 1 of 6 (17%) receiving Cytoxan plus Adriamycin
(doxorubicin) (CA). Thirteen of 35 patients (37%) who subsequently had
relapse of brain metastases were retreated successfully with secondary
chemotherapy. The median survival for CR and PR was 39.5 months and 10.5
months, respectively, in contrast with nonresponder patients who had a
median survival of 1.5 months. Thirty-one percent of all treated
patients survived more than 12 months.

These findings suggest that the chemotherapeutic agents used penetrate
the blood-brain barrier inducing regression of brain metastases. This
approach offers a significant benefit by simultaneously controlling
extracranial disease, improving the response and prolonging survival.

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Accepted: 29 November 1985

Oh, how I loved finding this info dated 23 years ago!

10-12-2008, 08:05 AM	#2
pattyz Senior Member Join Date: Mar 2006 Posts: 306	Chemotherapy induces regression of brain metastases in breast carcinoma Chemotherapy induces regression of brain metastases in breast carcinoma Dutzu Rosner, MD , Takuma Nemoto, MD, Warren W. Lane, PHD Departments of Breast Surgery and Biomathematics, Roswell Park Memorial Institute, Buffalo, New York Correspondence to Dutzu Rosner, Department of Breast Surgery, Roswell Park Memorial Institute, 666 Elm Street, Buffalo, NY 14263 Funded by: National Cancer Institute, Department of Health and Human Services.; Grant Number: CA-16056 Abstract: This study improves treatment options and ultimately survival by using systemic chemotherapy in brain metastases from breast carcinoma, since most of these patients have disseminated disease and a dismal prognosis when treated by conventional brain irradiation alone. One hundred consecutive patients with symptomatic brain metastases documented by radionuclide and/or computerized tomography scan were treated with systemic chemotherapy. Fifty of 100 patients demonstrated an objective response of brain metastases which was similar for extracranial metastases. There were 10 complete responders (CR), 40 partial responders (PR), 9 stable, and 41 nonresponders. Median duration of remission was 10+ months for CR and 7 months for PR (range, 2-72 months). Primary chemotherapy of brain metastases yielded responses in 27 pf 52 patients (52%) treated with Cytoxan (cyclophosphamide) (C), 5-fluorouracil (F) and prednisone (P); 19 of 35 (54%) receiving CFP-methotrexate (M) and vincristine (V); 3 of 7 (43%) treated with MVP, and 1 of 6 (17%) receiving Cytoxan plus Adriamycin (doxorubicin) (CA). Thirteen of 35 patients (37%) who subsequently had relapse of brain metastases were retreated successfully with secondary chemotherapy. The median survival for CR and PR was 39.5 months and 10.5 months, respectively, in contrast with nonresponder patients who had a median survival of 1.5 months. Thirty-one percent of all treated patients survived more than 12 months. These findings suggest that the chemotherapeutic agents used penetrate the blood-brain barrier inducing regression of brain metastases. This approach offers a significant benefit by simultaneously controlling extracranial disease, improving the response and prolonging survival. ---------------------------------------------------------------------- ---------- Accepted: 29 November 1985 Oh, how I loved finding this info dated 23 years ago!